This document discusses drugs that affect the autonomic nervous system. It begins by defining the divisions of the nervous system, including the central nervous system, peripheral nervous system, somatic nervous system, and autonomic nervous system. It then focuses on the autonomic nervous system and its sympathetic and parasympathetic divisions. The rest of the document discusses the anatomy and functions of adrenergic receptors, the effects of adrenergic and adrenergic blocking drugs, and important nursing considerations for these drug classes.
New product dedisions provide a dear path to the business. New product development
astep by step process. A Complete idea is required behind new product.
1 1deal Generation: The development of a product starts with the concept and idea.
The remaining process is depending on that idea.
2 Screening of Idea: This step is cruial to ensure that unsuitable ideas, for whatever
reason, are rejected as soon as possible. Ideas need to be considered objectively,
ideally by a group or committee.
3. Concept Development and Testing: After having an idea, next is the sreening
stage. The idea should now convert into concept. It has depth information which can
be visualizing by the consumer.
4. Anaysis of business: After finalization of concept, a business case needs to be kept
algTStogether to consider whether the new service /product will be gainful.
2665.Product Development If the nev product is approved, it will be approved to the
2marketing and technical development step.
6. Test Marketing: Market testing (test marketing or) is different to consumer testing.
in that it introduces the product that follows proposed plan of marketing.
od7. Commercialization: When the concept has been tested and developed, final
0decisions are required to move the product to its introduction into the market.
8. Launch: A detailed plan of launch is required for this step. This is the important
stage for success of a product
New Drug Development
So In present business atmosphere, it is more important to take smart decisions for
business. Innovative approaches and new products can put an organization on proper
pathway and to make a big success if appropriately analyzed and executed. Make it simpler
(Fig.2.1).0
Following parameters should keep in mind for a better decision:
Analyzing existing service and product portfolio frequently.
Knowing the position of functions of business, projects of departments and
initiatives.
Understanding the distribution of funds and assessing efficiency.
Having understanding of market for new opportunities and possible competition.
2.B PRODUCT BRANDING, PACKAGING AND LABELLING DECİSIONs
2.8.1 Branding
Branding has its existence from ancient era. According to Nilson (2000), the first example
of branding is found in the oil lamps' manufacture on the Greek islands thousands of years
back. Brand elements are name, sign, term, symbol, design or distinguishing characteristics.
Brand is not only a graphical design or a logo; it is the unique identity of the product.
By American Marketing Association, Brand can be defined as name, term, sign, symbol
or design, or a combination of them intended to identijy the goods and services of one seller or
group of sellers and to diferentiate them from those of other sellersa54
Branding is a process, where a company generates loyalty among consumers in the
market. Brands are designed with a motive to communicate customers the reason for the
existence of their product. Brand should have a strong connection with customers;
New product dedisions provide a dear path to the business. New product development
astep by step process. A Complete idea is required behind new product.
1 1deal Generation: The development of a product starts with the concept and idea.
The remaining process is depending on that idea.
2 Screening of Idea: This step is cruial to ensure that unsuitable ideas, for whatever
reason, are rejected as soon as possible. Ideas need to be considered objectively,
ideally by a group or committee.
3. Concept Development and Testing: After having an idea, next is the sreening
stage. The idea should now convert into concept. It has depth information which can
be visualizing by the consumer.
4. Anaysis of business: After finalization of concept, a business case needs to be kept
algTStogether to consider whether the new service /product will be gainful.
2665.Product Development If the nev product is approved, it will be approved to the
2marketing and technical development step.
6. Test Marketing: Market testing (test marketing or) is different to consumer testing.
in that it introduces the product that follows proposed plan of marketing.
od7. Commercialization: When the concept has been tested and developed, final
0decisions are required to move the product to its introduction into the market.
8. Launch: A detailed plan of launch is required for this step. This is the important
stage for success of a product
New Drug Development
So In present business atmosphere, it is more important to take smart decisions for
business. Innovative approaches and new products can put an organization on proper
pathway and to make a big success if appropriately analyzed and executed. Make it simpler
(Fig.2.1).0
Following parameters should keep in mind for a better decision:
Analyzing existing service and product portfolio frequently.
Knowing the position of functions of business, projects of departments and
initiatives.
Understanding the distribution of funds and assessing efficiency.
Having understanding of market for new opportunities and possible competition.
2.B PRODUCT BRANDING, PACKAGING AND LABELLING DECİSIONs
2.8.1 Branding
Branding has its existence from ancient era. According to Nilson (2000), the first example
of branding is found in the oil lamps' manufacture on the Greek islands thousands of years
back. Brand elements are name, sign, term, symbol, design or distinguishing characteristics.
Brand is not only a graphical design or a logo; it is the unique identity of the product.
By American Marketing Association, Brand can be defined as name, term, sign, symbol
or design, or a combination of them intended to identijy the goods and services of one seller or
group of sellers and to diferentiate them from those of other sellersa54
Branding is a process, where a company generates loyalty among consumers in the
market. Brands are designed with a motive to communicate customers the reason for the
existence of their product. Brand should have a strong connection with customers;
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
6. Nervous System Overview
Nervous System
Brain
Spinal cord
Nerves
Functions of nervous system
Regulates and coordinates all body
activities
Center of all mental activity, including
thought, learning, and memory
7. Central Nervous System (CNS)
Brain
Spinal Cord
Processes and stores sensory and motor
information
Controls consciousness
Peripheral Nervous System (PNS)
12 Pairs of Cranial Nerves
31 Pairs of Spinal Nerves
Transmits sensory and motor impulses back and
forth between CNS and rest of body
Nervous System Divisions
8. Peripheral Nervous System
Somatic Nervous System (SNS)
Provides voluntary control over skeletal
muscle contractions
Autonomic Nervous System (ANS)
Provides involuntary control over
smooth muscle, cardiac muscle, and
glandular activity and secretions in
response to the commands of the
central nervous system
10. Catecholamines
Substances that can produce a sympathomimetic
response
1. Endogenous:
Dopamine (Dopaminergic) epinephrine &
norepinephrine (Adrenegeric)
2. Synthetic:
isoproterenol, dobutamine, phenylephrine
11. Fight or Flight Response:
These catecholamine hormones facilitate immediate physical
reactions These include the following:
Acceleration of heart and lung action・Inhibition of stomach
and intestinal action
Constriction of blood vessels in many parts of the body
Dilation of blood vessels for muscles
Inhibition of tear glands and salivation
Dilation of pupil
Relaxation of bladder
Inhibition of erection
12. Dopaminergic Receptors
An additional adrenergic receptor
Stimulated by dopamine
Causes dilation of the following
blood vessels, resulting in
INCREASED blood flow
Renal
Mesenteric
Coronary
Cerebral
13. Adrenergic Agents
Drugs that stimulate the sympathetic
nervous system (SNS)
Also known as:
adrenergic agonists or sympathomimetics
Mimic the effects of the SNS neurotransmitters:
norepinephrine (NE) and epinephrine (EPI)
14. Adrenergic Receptors
Located throughout the body
Are receptors for the sympathetic
neurotransmitters
Alpha-adrenergic receptors:
respond to NE
Beta-adrenergic receptors: respond
to EPI
15. Types of -adrenergic receptor
-adrenergic receptors are adrenergic receptors that respond
to norepinephrine and to such blocking agents as
phenoxybenzamine.
They are subdivided into two types:
1, found in smooth muscle, heart, and liver, with effects
including vasoconstriction, intestinal relaxation, uterine
contraction and pupillary dilation,
2, found in platelets, vascular smooth muscle, nerve termini,
and pancreatic islets, with effects including platelet aggregation,
vasoconstriction, and inhibition of norepinephrine release and of
insulin secretion.
16. -receptor types
-adrenergic receptors respond particularly to
epinephrine and to such blocking agents as
propranolol.
There are three known types of beta receptor,
designated β1, β2 and β3.
β1-Adrenergic receptors are located mainly in the
heart.
β2-Adrenergic receptors are located mainly in the
lungs, gastrointestinal tract, liver, uterus, vascular
smooth muscle, and skeletal muscle.
β3-receptors are located in fat cells.
17. What do the receptors do?
Activation of receptors leads to smooth
muscle contraction
Activation of 2 receptors leads to smooth
muscle relaxation
Activation of 1 receptors leads to smooth
muscle contraction (especially in heart)
18. Clinical Utility of drugs which affect the adrenergic nervous
system:
a. Agonists of the 2 receptors are used in the
treatment of asthma (relaxation of the smooth muscles of
the bronchi)
b. Antagonists of the 1 receptors are used in the
treatment of hypertension and angina (slow heart and
reduce force of contraction)
c. Antagonists of the 1 receptors are known to
cause lowering of the blood pressure (relaxation of smooth
muscle and dilation of the blood vessels)
19. Drug Effects of Adrenergic Agents
Stimulation of alpha-adrenergic receptors on smooth
muscles results in:
Vasoconstriction of blood vessels
Relaxation of GI smooth muscles
Contraction of the uterus and bladder
Male ejaculation
Decreased insulin release
Contraction of the ciliary muscles of the eye
(dilated pupils)
20.
21. Drug Effects of Adrenergic Agents
Stimulation of beta2-adrenergic
receptors on the airways results in:
Bronchodilation (relaxation of the
bronchi)
Uterine relaxation
Glycogenolysis in the liver
22.
23. Drug Effects of Adrenergic Agents
Stimulation of beta1-adrenergic receptors on
the myocardium, AV node, and SA node
results in CARDIAC STIMULATION:
Increased force of contraction
(positive inotropic effect)
Increased heart rate
(positive chronotropic effect)
Increased conduction through the AV node
(positive dromotropic effect) automaticity
24. Adrenergic Agents:
Therapeutic Uses
1. Anorexiants: adjuncts to diet in the short-term
management of obesity
Examples: benzaphetamine
phentermine
dextroamphetamine
Dexedrine
2.Bronchodilators: treatment of asthma and bronchitis
Agents that stimulate beta2-adrenergic receptors
of bronchial smooth muscles causing relaxation
Examples:
albuterol ephedrine epinephrine
isoetharine isoproterenol levalbuterol
metaproterenol salmeterol terbutaline
25. Adrenergic Agents: Therapeutic Uses
3. Reduction of intraocular pressure and mydriasis (pupil
dilation): treatment of
open-angle glaucoma
Examples: epinephrine and dipivefrin
4. Nasal decongestant:
Intranasal (topical) application causes constriction
of dilated arterioles and reduction of nasal blood
flow, thus decreasing congestion.
Examples:
epinephrine ephedrine naphazoline phenylephrine
tetrahydrozoline
26. 5. Ophthalmic relieving conjunctival congestion.
Examples:epinephrine naphazoline
phenylephrine tetrahydrozoline
6. Vasoactive sympathomimetics also called cardio selective
sympathomimetics
Used to support the heart during cardiac failure or shock.
Examples:
dobutamine dopamine ephedrine epinephrine
fenoldopam isoproterenol methoxamine
norepinephrine phenylephrine
29. Adrenergic Agents:
Nursing Implications
Assess for allergies and history of
hypertension, cardiac dysrhythmias, or other
cardiovascular disease.
Assess renal, hepatic, and cardiac function
before treatment.
Perform baseline assessment of vital signs,
peripheral pulses, skin color, temperature,
and capillary refill. Include postural blood
pressure and pulse.
Follow administration guidelines carefully.
30. Adrenergic Agents: Nursing Implications
With chronic lung disease:
Instruct patients to avoid factors that
exacerbate their condition.
Encourage fluid intake
(up to 3000 mL per day) if permitted.
Educate about proper dosing and
equipment care.
31. Adrenergic Agents: Nursing Implications
Overuse of nasal decongestants may cause
rebound nasal congestion or ulcerations.
Monitor for therapeutic effects
(cardiovascular uses):
Decreased edema
Increased urinary output
Return to normal vital signs
Improved skin color and temperature
Increased LOC
32. Adrenergic Agents: Nursing Implications
Monitor for therapeutic effects (asthma):
Return to normal respiratory rate
Improved breath sounds, fewer rales
Increased air exchange
Decreased cough
Less dyspnea
Improved blood gases
Increased activity tolerance
33. Adrenergic-Blocking Agents
Bind to adrenergic receptors, but inhibit or block
stimulation of the sympathetic nervous system (SNS)
Have the opposite effect of adrenergic agents
Also known as
adrenergic antagonists or sympatholytics
34. Adrenergic-Blocking Agents:
Drug Effects and Therapeutic Uses
Alpha-Blockers
Cause both arterial and venous dilation,
reducing peripheral vascular resistance and
BP
Used to treat hypertension
Effect on receptors on prostate gland and
bladder decreased resistance to urinary
outflow, thus reducing urinary obstruction
and relieving effects
of BPH
35. Beta Blockers: Mechanism of
Action
Cardioselective (Beta1)
Decreases heart rate
Prolongs SA node recovery
Slows conduction rate through the
AV node
Decreases myocardial contractility,
thus decreasing myocardial oxygen
demand
36. Beta Blockers: Therapeutic
Uses
1. Anti-angina:decreases demand for myocardial
oxygen
2. Cardioprotective:inhibits stimulation by
circulating catecholamines
3. Class II antidysrhythmic
4. Antihypertensive
5. Treatment of migraine headaches
6. Glaucoma (topical use)
37. Adrenergic Blocking Agents:
Nursing Implications
Assess for allergies and history of COPD,
hypotension, cardiac dysrhythmias,
bradycardia, CHF, or other cardiovascular
problems
Remember that alpha blockers may
precipitate hypotension.
Remember that beta blockers may
precipitate bradycardia, hypotension,
heart block, CHF, and bronchoconstriction.
38. Encourage patients to take medications
as prescribed.
These medications should never be stopped abruptly.
Report constipation or the development of any urinary or
bladder distention.
Rebound hypertension or chest pain may occur if this
medication is discontinued abruptly.
Patients should notify their physician if they become ill and
unable to take medication.
Inform patients that they may notice a decrease in their
tolerance for exercise; dizziness and fainting may occur with
increased activity. Notify the physician if these problems
occur.
39. Beta Blocking Agents:
Nursing Implications
Patients should report the following to
their physician:
1. Weight gain of more than 2 pounds (1 kg)
within a week
2. Edema of the feet or ankles
3. Shortness of breath
4. Excessive fatigue or weakness
5. Syncope or dizziness